The present invention relates to an apparatus and method for diagnosing swallowing disorders (dysphagia) using high resolution manometry and in particular to a computerized method providing automatic or semiautomatic analysis of complex high resolution manometry data.
Eating and drinking, the primary means by which we meet nutritional requirements, necessitates the ability to swallow. Approximately 15 million Americans suffer from swallowing disorders. Individuals of any age can be affected and disorders are particularly likely in persons with any neurological disorder, acid reflux, and cancer of the head and neck. Dysphagia affects the aging population and the leading cause of death in Parkinson's disease is aspiration pneumonia, a result of being unable to protect the airway during swallowing.
Videofluoroscopy is a primary examination tool providing information on swallowing disorders and can provide information on bolus transit, residue, and aspiration used to guide assessment and therapy. The Modified Barium Swallow Impairment Profile (MBSImP), when used with videofluoroscopy, provides a method of standardized videofluoroscopic assessment that provides measures of 17 diagnostic components characterizing the oral, pharyngeal, and esophageal phases of swallowing. By viewing x-ray images, highlighted with a barium contrast agent, trained individuals can extract the MBSImP components to accurately describe the movement and timing of various structures associated with swallowing and to diagnose swallowing disorders.
While videofluoroscopy is a valuable tool for assessing swallowing disorders, videofluoroscopic examination requires radiation exposure and its associated risk to patients. Additionally, such x-ray examinations normally require that the patient be moved to the radiology suite, which may be difficult or impractical for some patients, and are a relatively poor predictor of aspiration pneumonia.
Thus, it would be beneficial to develop an assessment of swallowing that can provide information similar to that provided by videofluoroscopy but does not require radiation exposure and that can also be performed easily at the bedside. Such an assessment would also be amenable to serial measurements and evaluation of patient progress over time, as the exam could be performed quickly and accumulative radiation would not be a concern.